Or have you diagnosed the wrong problem first?
The day a good leader starts looking like the wrong leader is rarely the day the problem begins.
By the time most boards begin discussing whether to replace a senior executive, the organisation has usually been changing for months. That matters because replacing the wrong executive doesn’t simply cost time and money. It can lock the organisation into solving yesterday’s problem while tomorrow’s quietly gathers momentum.
The difficulty is that organisations rarely announce these moments. They whisper through meetings that take a little longer. Decisions that need revisiting. Priorities that become harder to reconcile. Conversations that leave everyone feeling aligned, yet somehow no closer to action.
Most boards don’t ignore these signals because they’re inattentive. They ignore them because each one appears perfectly reasonable on its own. A delayed decision can be blamed on a busy diary. Slower execution can be explained by regulatory complexity. A frustrated executive can be put down to the pressures of growth.
Viewed individually, none of these observations justifies concern. Viewed together, they tell a very different story.
The Wrong Question
This is where many board conversations quietly take a wrong turn. The discussion turns to whether the executive is still the right person for the role.
It is a reasonable question. It is just not the first question.
The first question is whether the organisation has quietly become something different from the one that executive was originally appointed to lead.
The change is rarely dramatic. There is no announcement that the organisation has crossed an invisible line. Complexity simply accumulates. A new geography is added. A regulatory pathway becomes more demanding. The customer buying process changes. Another acquisition is integrated. One product becomes five. One leadership meeting becomes three.
None of these developments is unusual. In fact, they are often signs of success. Taken together, however, they create an organisation that no longer makes decisions at the same speed, serves customers in the same way or requires the same kind of leadership it did only a few years earlier.
Yet the role itself often remains remarkably unchanged. The job description evolves slowly. The expectations evolve even more slowly. Boards continue judging today’s executive against yesterday’s definition of success.
Growth Changes More Than Strategy
This is why good leaders can begin to look like the wrong leaders. Not because they have become less capable but because the organisation has changed around them.
Every leadership role is created for a particular organisation at a particular point in its evolution. As the business grows, that relationship changes whether anyone acknowledges it or not.
The danger is not growth. The danger is assuming that yesterday’s role is still capable of delivering tomorrow’s strategy.
That assumption sits quietly beneath countless leadership discussions. It rarely appears in board papers. It is almost never debated explicitly. Yet it shapes some of the most expensive decisions a board will ever make.
What the Best Organisations Do Differently
Looking back over more than thirty years since starting in MedTech, I have become increasingly interested in the organisations that seemed to sustain high performance while others struggled with the growing complexity that success inevitably brings.
Early in my career, I joined KeyMed (1996). The Theatre Products market was effectively shared between three major players: KeyMed, Stryker and Karl Storz. Although I didn’t ultimately work in that division, I spent time training with the Theatre Products team, and one thing quickly became apparent.
Stryker had earned a reputation as an exceptionally well-run organisation. At the time, I accepted that as part of the competitive landscape. Looking back, I think there was a deeper reason.
Many companies employ talented people. Far fewer continually adapt the organisation those people are being asked to lead.
What made Stryker stand out was not simply commercial success. It was the way leadership responsibility stayed close to customers. Managers were trusted to make decisions. Accountability did not constantly migrate upwards as the organisation became larger.
The lesson wasn’t that Stryker found better leaders. The lesson was that they continually evolved leadership as the organisation evolved.
Good leaders remained effective because the organisation never left yesterday’s roles trying to solve tomorrow’s challenges.
The Most Expensive Leadership Mistake
Unfortunately, many organisations discover this too late. An executive comes under pressure. Performance begins to flatten. Confidence starts to fade. The board concludes that fresh leadership is needed. A search begins.
Six months later, a highly capable successor arrives. Twelve months after that, remarkably similar conversations begin to surface again. Not because either executive lacked capability but because both inherited a role designed for an organisation that no longer existed.
The financial cost of replacing a senior executive is relatively easy to calculate.
- Search fees.
- Notice periods.
- Recruitment costs.
- Onboarding.
- Lost productivity.
Those costs appear in the board papers but the larger costs rarely do.
A product launch slips because key decisions slow while a replacement is found. Commercial momentum weakens because accountability becomes blurred.
The leadership team becomes more cautious while everyone waits for the new executive to establish credibility.
The organisation loses another year. And when the new executive encounters exactly the same constraints as their predecessor, the cycle quietly begins again.
The most expensive executive search is not the one that fails but the one that successfully fills the wrong role.
Before You Decide
Before I accept a retained search assignment, I rarely begin with candidates.
I begin with questions. Not because the answers are easy but because the quality of those answers usually determines whether a search is the right solution in the first place.
Here are five of those questions.
1. If this executive joined your organisation today, would you write exactly the same role specification?
2. Which assumptions about your organisation were true when this executive was appointed, but are no longer true today?
3. Has the organisation become more complex than the leadership role was ever designed to support?
4. Are you trying to solve a leadership problem, or an organisational problem that is now showing itself through leadership?
5. If you appoint someone new tomorrow without changing the role itself, what makes you confident you’ll achieve a different outcome?
The questions rarely produce immediate answers. What they do produce is clarity.
More than once, they have changed the direction of a board discussion before a search had even begun.
The next time a leadership role no longer feels like the right fit, don’t begin by asking who has changed. Begin by asking whether the organisation has.
If these questions have prompted a different conversation in your own mind, I’d be happy to share the remaining fifteen. Most of my strongest client relationships have started the same way: a thoughtful exchange of messages, a short video call and, if we both believe there’s value in continuing, coffee and cake.
About the Author
Harun Rabbani is the Founder of Precilium, where he advises Chairs, CEOs and Boards of scaling MedTech and HealthTech companies on the leadership decisions that shape long-term growth.
His perspective is shaped by an unusual combination of experience across medical technology, executive search and leadership advisory. Having started his career with KeyMed and Gyrus before specialising in strategic search, he has spent many years observing why some organisations continue to execute as they scale while others quietly lose momentum.
Today, his work sits upstream of executive search. Before discussing candidates, he helps boards determine whether they are solving the right leadership problem in the first place. That often begins with a conversation, followed by a short video call and, if there’s mutual value in continuing, coffee and cake.
Frequently Asked Questions
How do I know whether I have a leadership problem or an organisational problem?
That is often the hardest question for a board to answer objectively. Leadership performance is always visible. Organisational issues rarely are. The purpose of the twenty-question diagnostic is to help distinguish between the two before significant decisions are made.
Should a board complete the diagnostic before starting an executive search?
Ideally, yes. A retained search is designed to identify the right person. The diagnostic helps determine whether the role itself still reflects the organisation’s current and future needs. Getting that sequence right can save months of disruption and avoid solving the wrong problem.
Does this mean we should never replace a senior executive?
Not at all. Sometimes a leadership change is exactly the right decision. The objective is simply to ensure the board has diagnosed the underlying issue before deciding that replacement is the answer.
Who is the diagnostic designed for?
The conversations are typically most valuable for Chairs, CEOs and Boards of scaling MedTech and HealthTech companies that are experiencing rapid growth, increasing organisational complexity or preparing for significant strategic change.
What happens after the diagnostic?
Many organisations gain the clarity they need from the conversation alone. Others decide to redesign leadership roles, strengthen board alignment or begin a retained search with greater confidence that they are appointing for the organisation they are becoming, not the one they have already outgrown.
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